1. Personal Information Full Name: Date of Birth: Gender: MaleFemaleOther Phone (WhatsApp): Email Address: Nationality: Father’s Name: Father’s Contact Number: Mother’s Name: Mother’s Contact Number: Permanent Address: 2. Course Enrollment Select Your Course: IELTSPre-IELTS CourseIELTS with GrammarIELTS RegularIELTS Crash CourseIELTS Life SkillsLife in the UK TestOET (Occupational English Test)English Grammar & WritingProfessional EnglishSpoken EnglishKids English Customized Program: 3. Batch Preference Online Batch Options (via Zoom): Regular Batch (12 Students)Standard Batch (8 Students)Premium Batch (4 Students)One-to-One Online Coaching (Personalized) Offline/In-Person Batch Options: Elite Batch (6 Students)High-Priority Batch (4 Students)One-to-One In-Person Coaching (Personalized) 4. Academic Background Last Academic Qualification: Institution Attended: Current English/IELTS Level (if any): 5. Emergency Contact Contact Name: Relationship: Phone Number: 6. Additional Notes (If Any) 7. Student Declaration I hereby declare that the information provided above is true and accurate. I understand that admission is subject to LuSi’s English policies. I agree to attend classes regularly, complete homework, and maintain a respectful learning environment. Student Signature (Full Name): Date: 8. Payment Payment Method: CashBkashBank TransferCard TRX ID: Payment Status: PaidPartialPending Remarks:
